Leveraging the benefits of systemic therapy to tailor surgery
Menée auprès de 527 patientes atteintes d'un cancer du sein HER2+ ou triplement négatif (âge médian : 51 ans), cette étude évalue la possibilité d'utiliser la réponse pathologique complète après une chimiothérapie néo-adjuvante pour identifier les patientes présentant un faible risque de métastases axillaires et pouvant ainsi éviter un curage axillaire
Improvements in systemic therapy for breast cancer have increased the rates of pathologic complete response (pCR) in patients receiving neoadjuvant chemotherapy (NCT), offering the opportunity to decrease, and perhaps eliminate, surgery in patients who have a pCR. In this issue of JAMA Surgery, Tadros et al1 examine the association between breast pCR and nodal pCR in patients with stages I and II triple-negative or HER2 (now ERBB2)-overexpressing breast cancers. Of no surprise, they find that responses in the breast and nodes are parallel. In the 116 patients with clinically negative nodes at presentation and a breast pCR, 100% had negative nodes after NCT. In those with nodal metastases at presentation, 69 of 77 (89.6%) with a breast pCR had negative nodes compared with only 68 of 160 (42.5%) who had residual disease in the breast.
JAMA Surgery , commentaire, 2016